Cancer research collaboration accelerates diagnosis and patient selection
Researchers at Walter Reed National Military Medical Center, Murtha Cancer Center Research Program, and Uniformed Services University (USU) recently published a groundbreaking collaborative study showing that cancer patients treated within the Military Health System (MHS) Cancer diagnoses are often received earlier than for privately insured or Medicaid patients.
The study “Cancer Stage at Diagnosis: Comparison of SEER and Department of Defense Cancer Registry Insurance Status,” published in Cancer Medicine, continues to spark discussion within the cancer research community.
“Everything we do in the MCCRP study involves collaboration and team science because the complexity of analyzing the massive Department of Defense (DOD) data sets and the statistical expertise involved is considerable,” said project director, retired U.S. Army Col. Craig Shriver shares. Director of the Murtha Cancer Center and professor of surgery at USU.
Shriver also serves as director of the congressionally mandated Clinical Breast Cancer Program (CBCP), a civil-military alliance that provides excellence in clinical care, cutting-edge breast cancer research, and a broad range of human breast cancer and tissue research used worldwide Human biobanking.
U.S. Navy Lieutenant James T. Flanary, lead author of the Cancer Medicine study, led the study in collaboration with Drs. James T. Flanary. Lin, J., Shriver, and Kang-min Zhu.
MHS patients are diagnosed with cancer earlier than the general U.S. population
“Early detection of cancer can reduce mortality, and in order to detect and diagnose malignancy, a person must have access to medical care,” the study outlines. “Currently, the United States still does not have the means to provide effective health care to the entire population.”
The study population included patients aged 18 years or older with first-time invasive lung, prostate, breast, or colon cancer histologically diagnosed between January 1, 2007, and December 31, 2013. According to the authors, cancer was the most common in these four patients in terms of morbidity and mortality during this period.
Murtha Cancer Center Research Initiative: Improving Resilience and Readiness
Shriver shared that one of MCCRP’s missions is to detect and treat cancer as a readiness issue for active duty troops. The lives of his family, friends and colleagues have been impacted by colon cancer.
“Colon cancer is one of the few cancers that can be screened very effectively, which can also prevent colon cancer by removing small, non-cancerous polyps before they become cancerous,” explained Shriver, encouraging stakeholders to undergo regular colon cancer screening Screening age should be no later than 45 years.
MHS Universal Health Care vs. Private Health Care and Medicaid
“MHS provides universal health care to its beneficiaries,” the authors note. “Our previous studies have shown that MHS beneficiaries have earlier stages of colon, breast, and lung cancer compared with the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry. However, these studies did not Segmenting the SEER population by insurance status category. Comparing each insurance status to the MHS provides more granular evidence of its association with stage at diagnosis.” explain the authors.
MHS patients were diagnosed earlier with breast, prostate, colon and lung cancers relative to the Medicaid and uninsured groups, the researchers said.
“The most significant system-related differences [DOD Automated Central Tumor Registry] The difference between ACTUR and SEER and the SEER insurance group is the cost and fee schedule,” the authors note. “Costs for uninsured patients tend to be prohibitive, which may explain why uninsured patients have the highest odds of late diagnosis. Costs for privately insured patients vary widely. Some have lower out-of-pocket costs, while others face higher costs for private insurance beneficiaries, at least $4,000 more than MHS. Therefore, out-of-pocket costs may contribute to the observed differences in stage AD diagnoses between the MHS and SEER insurance groups,” the authors speculate.
Later diagnoses among Medicaid patients cannot be explained by continued sharing because these patients have very low out-of-pocket costs. “Uninsured patients are often enrolled in and classified as Medicaid soon after a new cancer diagnosis. This also may lead to later-stage diagnoses in this group,” the study states.
Overall, the researchers suggest, Medicaid patients “face more barriers in finding doctors who accept their insurance and are more likely to delay care due to cost, all of which may lead to delays in diagnosis.” Delays in appointment times may also be was a factor influencing stage of diagnosis between the ACTUR and SEER insurance groups, particularly in the case of lung cancer; waiting times for MHS appointments were shorter than reported in another survey of civilian physicians,” the authors explained.
The authors also emphasize that their study was conducted before the Affordable Care Act eliminated out-of-pocket costs for cancer screenings that were not previously covered.
More MHS research is coming
Shriver noted that several ongoing studies are examining other aspects of cancer diagnosis and treatment in MHS compared with the general population, which may help inform the quality of care provided to military families.
Meanwhile, Murtha is leading a task force meeting on February 24 at the annual meeting of the Society of Military Surgeons of the United States (AMSUS) to discuss the study, published in the journal Cancer Medicine.
|January 29, 2024
|January 29, 2024 13:18
|Bethesda, Maryland, United States
This work, Early cancer diagnosis within military health system inspires public confidencego through James Blakeidentified as DVIDSsubject to the restrictions shown at https://www.dvidshub.net/about/copyright.